Education

Most infections in children are caused by viruses, but they can also be caused by bacteria. Bacteria can live in certain parts of the body without causing any harm. They cause infections when they move to parts of the body where they do not belong. They can also come into the body from the outside; in the body they can cause an infection that requires treatment with an antibiotic. Most viral diseases are not treated with an antibiotic because antibiotics do not work on viruses. Instead, the body gets rid of viruses on its own. When your child has a virus, your pediatrician will tell you how to make your child more comfortable. You should also make sure your child gets plenty of rest and eats a balanced diet.

Bronchiolitis is a common disease of the lower respiratory tract (the bronchioles). It occurs most often in the winter. Bronchiolitis causes coughing, wheezing, and breathing trouble. It is most commonly found in children under 2 years of age. It often develops in infants and toddlers after they come into contact with someone who has an upper respiratory tract illness. Bronchiolitis starts like a normal cold, with a runny nose and sneezing. After a few days, a child with bronchiolitis will develop a wheezy cough and trouble breathing. She may be cranky too. The cough and breathing problems may make it hard for her to eat. In some infants with severe bronchiolitis, symptoms appear much more quickly. Bronchiolitis is usually caused by a virus that leads to swelling of the small bronchial tubes. This traps air and mucus in the lungs. Children with mild cases, especially those with a thick nasal mucus, may get some relief with a cool-mist vaporizer. A child who has a lot of trouble breathing may need to go to the hospital for oxygen and fluids. Sometimes medication may be used to help open the bronchial tubes and improve breathing. A specific virus called respiratory syncytial virus (RSV) can cause bronchiolitis. If infection with RSV is severe or occurs in infants who also have a chronic illness (especially heart disease or lung disease), an antiviral agent called ribavirin (Virazole) can be used in the treatment.

We all know the symptoms of the common cold — sneezing, watery eyes, a cough, and a stuffy, runny nose. A child with a cold will often be cranky and have a mild fever and a headache. Since there are hundreds of viruses that cause colds, there is still no vaccine for the common cold. Symptoms can be relieved with:
        • a cool-mist vaporizer
        • acetaminophen to bring down a fever
        • decongestants
        • lots of fluids A cold usually lasts about a week.

Any fever should appear at the beginning of the cold and then go away. Contact your pediatrician if:
        • a fever continues or goes up during the week,
        • symptoms seem to get worse after a week, or
        • your child has problems breathing or ear pain.

Pinkeye is an infection that causes painful or itchy, red eyes. The undersides of your child’s eyelids may also be irritated. To treat pinkeye, your pediatrician may prescribe warm compresses and antibiotic drops or ointment. If the redness and swelling remain after a few days of treatment, it may mean a virus or allergy is causing the pinkeye. Let your pediatrician know if your child has eye irritation with a high fever, sluggishness, or more severe swelling and redness around the eye. These could be signs of a more serious infection. Not all pinkeye infections are contagious. Your pediatrician can let you know whether your child should stay out of school or the child care center until the infection clears.

Croup is a scary illness for most parents because of its symptoms. Your child may go to bed with a runny nose and mild cough, but wake up during the night with a cough that sounds like a seal’s bark. Croup is usually caused by a viral infection in and around the voice box. Your child’s breathing may become noisy and labored, a condition called stridor. Your child may or may not have a fever. Most cases of croup can be handled at home with the advice of your pediatrician. A cool-mist vaporizer may help. If you do not have one, turn on the hot water in your shower or bathtub and let the bathroom fill up with steam. Stay with your child in the bathroom while he breathes in the steam for a few minutes. Keep a close eye on your child so that he does not burn himself with the hot water. (Try sitting with your child on your lap, and read a short story to pass the time.) Or you could take your child for a walk in the cool night air. This may help your child to breathe better. If your child has a severe case of croup, your pediatrician may recommend a hospital stay. During the stay, your child may need to be inside a plastic tent called a croup tent. To reduce the swelling around the voice box, doctors may give your child a cortisone medication or a medication to inhale.

Your child may have a skin infection called impetigo if a scratch turns into a yellow, oozing, crusty sore surrounded by redness. Impetigo can spread on the skin quickly. It can also spread to other people if they touch the infected skin lesions, by fingers, or from soiled clothing. This infection is most common in warm weather. An antibiotic, taken by mouth or in ointment form, is used to treat impetigo. If any of these illnesses or infections develop, remember that your pediatrician is your best source of help. Most important, if the illness or infection does not seem to go away, or appears to get worse, your pediatrician needs to know. Always call when you are concerned.

Pneumonia is an inflammation of the lungs. The symptoms vary based on the cause and severity of the illness. Viruses cause most pneumonias in children. Luckily these illnesses are mild. A child may have a cough, mild fever, and decreased appetite and energy. Viral pneumonias are often treated with acetaminophen for fever and are sometimes treated with bronchodilators (if there is wheezing). Bacterial pneumonias tend to have more severe symptoms, and they respond best to therapy with antibiotics, fluids, and humid air. Pneumonia often occurs a few days after the start of an upper respiratory tract infection. If one of the more severe types of pneumonia develops, your child may suddenly have shaking chills; a high fever; difficult, rapid breathing; and other breathing problems. A cough may not develop until later. In many cases your pediatrician may need an x-ray to make sure that pneumonia is the cause of the symptoms. Most cases of pneumonia can be safely treated at home. If the symptoms are severe or your child is under 6 months of age, however, he may need to go to the hospital for treatment.

These are the signs of infection in an infant under 2 months of age. Since infections can be especially dangerous in a child this young, call your pediatrician right away if your child develops any of these symptoms:
• poor feeding
• poor color
• listlessness
• weak cry
• rectal temperature of at least 100.4°F
• breathing problems
• unusual fussiness
• sleeping more than usual
• vomiting or diarrhea

When your child has a cold, the sinuses around his nose often get stuffy and swollen. Sometimes the mucus in the sinuses may get infected with bacteria. When this happens, your child has a sinus infection. Sinusitis usually develops after your child has had a cold for at least 10 days. Signs of sinusitis are:
        • persistent nasal discharge
        • fever
        • a cough during the day and night, that often gets worse at night
        • tenderness in the face
        • headaches
An antibiotic will destroy the bacteria that cause sinusitis.

Strep throat is a bacterial infection. On rare occasions it can lead to serious problems if not treated. Strep usually develops in children over 3 years of age. Signs of strep include a sore throat, fever, and swollen glands in the neck. (If there is also a skin rash, the condition is called scarlet fever.) Since many viruses can cause the same symptoms as strep, your pediatrician will need to test for strep to be sure your child has it. To do this, he or she will obtain a throat culture or do a rapid strep test. If your child does have strep throat, your pediatrician will prescribe an antibiotic that will destroy the strep germ. After 24 to 36 hours of antibiotic treatment, your child is no longer contagious and should start to feel better. Remember to have your child finish all the medicine. If you stop treatment too early, the infection may come back or cause other problems. If not treated, strep throat can lead to rheumatic fever. This can cause damage to the heart and swelling of the joints. Untreated strep throat can also lead to kidney disease and a number of other health problems.

A tender, local swelling and redness on your child’s eyelid are usually signs of a stye. This is an infection in a gland of the eyelid. To treat a stye, apply warm compresses often. Let your pediatrician know if this does not work. He or she may then prescribe an antibiotic ointment or refer your child to an eye doctor who can drain the stye surgically. Styes are not very contagious.

Urinary tract infections (UTIs) are found in children from infancy through adolescence. A UTI occurs in the kidney or bladder and can cause the following symptoms:
• fever
• painful and frequent urination
• vomiting
• abdominal pain
Treatment of UTIs consists of taking an antibiotic for about 10 days. Even though your child shows signs of improvement within 1 to 2 days of starting to take an antibiotic, he must still finish the entire prescription. X-rays and other tests are often needed to help determine the causes of the UTI.

Vomiting and diarrhea are the reasons many parents call the pediatrician. These illnesses are usually caused by viruses that infect the intestine. They usually last only about a day or two, but in some cases they can last up to a week. If your child is throwing up, your pediatrician may tell you to not give food and fluid for a few hours. You can then give your child small sips of clear fluids, later followed by easy-to-digest foods. This will help pre-vent more vomiting, which can lead to dehydration. Diarrhea is frequent, loose, watery stools. You may need to stop feeding your child solid foods and milk for 12 to 24 hours and instead give an oral electrolyte solution to prevent dehydration. You can buy this at your local drugstore. Giardia is a parasite that infects the bowel and often causes prolonged diarrhea. It can be a problem, especially for those in child care centers and rural areas. If your child’s diarrhea does not clear up, your pediatrician may test for Giardia. Disease caused by Giardia is treated with medication. Mild vomiting and diarrhea rarely cause dehydration. However, if your child is dehydrated, she may:
        • seem tired or have less energy
        • produce less urine or tears
        • have a dry mouth
        • have sunken eyes
Some children may throw up many times over several days.

If this occurs, and you notice any of the other symptoms listed previously, your pediatrician will want to examine your child. These symptoms may indicate dehydration or, less often, the first signs of a rare condition known as Reye syndrome. As Reye syndrome has been linked with taking aspirin during certain viral illnesses, you should never give aspirin to an infant or child. If dehydration occurs, your child may need to have an intravenous (IV) tube inserted to receive fluids through her veins. To reduce the chance of dehydration, call your pediatrician early if your child has vomiting or diarrhea that will not go away.